BANNER HEALTH PHYSICIANS COLORADO LLC
NPI 1750645099
Clinic/Center - Multi-Specialty in Greeley, CO

NPI Status: Active since July 02, 2012

Contact Information

5623 W 19TH ST
GREELEY, CO
ZIP 80634
Phone: (970) 353-9011
Fax: (970) 353-0306

NPI Profile Information
Primary Taxonomy
Authorized Official
CLIA Information
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Organization
Clinic/Center
Multi-Specialty
CLIA Number: 06D0878115
CLIA Cert. Type: Physician Office
CLIA Exp. Date: 07-31-2026

About BANNER HEALTH PHYSICIANS COLORADO LLC

This page provides the complete NPI Profile along with additional information for Banner Health Physicians Colorado Llc, a provider established in Greeley, Colorado operating as a Clinic/center, focusing in multi-specialty . The healthcare provider is registered in the NPI registry with number 1750645099 assigned on July 2012. The practitioner's primary taxonomy code is 261QM1300X. The provider is registered as an organization and their NPI record was last updated 13 years ago. The authorized official of this NPI record is Dennis Dahlen (Sr Vp Finance)

NPI: 1750645099
Provider Name: BANNER HEALTH PHYSICIANS COLORADO LLC
Entity Type: Organization
Location Address: 5623 W 19TH ST GREELEY, CO 80634
Location Phone: (970) 353-9011
Location Fax: (970) 353-0306
Mailing Address: 1441 N 12TH ST PHOENIX, AZ 85006
Is Sole Proprietor?: No
Is Organization Subpart?: Yes
Enumeration Date: 07-02-2012
Last Update Date: 07-02-2012
Code Navigator

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Clinic/Center Multi-Specialty
Taxonomy Code: 261QM1300X
Type: Ambulatory Health Care Facilities

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name: DENNIS DAHLEN
Authorized Official Title: SR VP FINANCE
Authorized Official Phone: (602) 747-4000

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number: 06D0878115
Facility Type: Physician Office
Certificate Effective Date: August 01, 2024
Certificate Expiration Date: July 31, 2026
Laboratory Director: DR. DAVID C. PUIS
Certificate Type: Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description: This CLIA certificate is issued to Banner Health Physicians Colorado Llc in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	7	5	0	6	4	5	0	9	9
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	7	10	0	12	4	10	0	18
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 1 + 0 + 0 + 1 + 2 + 4 + 1 + 0 + 0 + 1 + 8 + 24 = 51
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 51 = 9									9

The NPI number 1750645099 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.